| NPI | 1104336908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUALYN ROBINSON Owner 704-465-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 101YM0800X Counselor, Mental Health | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |